0000899243-21-017238.txt : 20210428 0000899243-21-017238.hdr.sgml : 20210428 20210428182410 ACCESSION NUMBER: 0000899243-21-017238 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210428 FILED AS OF DATE: 20210428 DATE AS OF CHANGE: 20210428 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gordon Christopher R CENTRAL INDEX KEY: 0001432313 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40362 FILM NUMBER: 21866251 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL, LLC STREET 2: JOHN HANCOCK TOWER, 200 CLARENDON STREET CITY: BOSTON STATE: MA ZIP: 02116 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Aveanna Healthcare Holdings, Inc. CENTRAL INDEX KEY: 0001832332 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] IRS NUMBER: 844717209 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 INTERSTATE NORTH PARKWAY STREET 2: STE 1700 CITY: ATLANTA STATE: GA ZIP: 30339 BUSINESS PHONE: 770-441-1580 MAIL ADDRESS: STREET 1: 400 INTERSTATE NORTH PARKWAY STREET 2: STE 1700 CITY: ATLANTA STATE: GA ZIP: 30339 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-04-28 0 0001832332 Aveanna Healthcare Holdings, Inc. AVAH 0001432313 Gordon Christopher R C/O BAIN CAPITAL INVESTORS, LLC 200 CLARENDON STREET BOSTON MA 02116 1 0 1 0 Common Stock, par value $0.01 per share 81029675 I See footnotes Represents shares of common stock held by Bain Capital Fund XI, L.P. ("Fund XI"), BCIP Associates IV (US), L.P. ("BCIP IV"), BCIP Associates IV-B (US), L.P. ("BCIP IV-B"), BCIP T Associates IV (US), L.P. ("BCIP T IV") and BCIP T Associates IV-B (US), L.P. ("BCIP T IV-B" and, together with Fund IX, BCIP IV, BCIP IV-B and BCP T IV, collectively, the "Bain Capital Entities"). Bain Capital Investors, LLC ("BCI") is the ultimate general partner of the Fund IX and governs the investment strategy and decision-making process with respect to investments held by BCIP IV, BCIP IV-B, BCIP T IV and BCIP T IV-B. Mr. Gordon is a Managing Director of BCI. As a result of the relationships described in this footnote, Mr. Gordon may be deemed to share voting and dispositive power with respect to the shares held by the Bain Capital Entities. Mr. Gordon disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein. /s/ Christopher R. Gordon 2021-04-28